Retrospective cohort study of trends in survival outcomes of patients with hepatocellular carcinoma

A retrospective cohort study among patients of Kaiser Permanente Northern California evaluated survival among patients with a diagnosis of hepatocellular carcinoma from 2006 to 2019. Among 3441 patients (75.0% men; median age 65 years; IQR 58-73), 34.7% received curative treatment, while 39.9% received noncurative treatment and 25.3% received no treatment. During follow-up until the end of 2020, 72.7% experienced all-cause mortality and 52.6% experienced HCC-specific mortality. Factors associated with higher all-cause mortality were age 70 years or older, male sex, BCLC stage C or D, high AFP level, noncurative treatment, and no treatment, while Asian or Other Pacific Islander race and ethnicity was associated with lower all-cause mortality. Survival improved in diagnosis era 2 (2013-2019; n=2007) compared with diagnosis era 1 (2006-2012; n=1434). The authors conclude that while overall survival remains low, there have been significant improvements in survival of HCC over the past decade.